Saturday, March 15, 2008

90 - test yourself - mcqs with answers and explanations - 101 to 200

101 - in glycolysis ?

ans- glucose in converted in 2 molecules of pyruvate by the synthesis of 2 NADH & 2 ATP molecules and utilisation of 2 ATP molecules .

- i dont wanna give u choices in this question because it confuses u a lot , so stick to the above statement .

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102 - flouride ion inhibits glycolysis by inhibiting the action of which enzyme ?

answer - enolase

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103 - claw hand occurs due to paralysis of which nerve ?

answer - ulnar nerve .

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104 - the superior rectal artery is a branch of ?

answer is inferior mesentric artery.

- blood supply of the rectum .

the superior rectal artery is a branch of the inferior mesentric artery

the middle rectal artery is a branch of the inferior vesical artery which is a branch of the internal iliac artery

the inferior rectal artery is a branch of the internal pudendal artery which is a branch of the internal iliac artery again

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105 - the terminal branches of external carotid artery are ?

answer - superficial temporal artery and maxillary artery .

the branches of the external carotid artery are :

mnemonic - SISTER LUCY'S POWDERED FACE OFTEN ATTRACTS MEDICAL STUDENTS .

SISTER - - superior thyroid artery

LUCY - lingual artery

POWDERED - posterior auricular artery

FACE - facial artery

OFTEN - occipital artery

ATTRACTS - ascending pharyngeal artery ( only medial branch )

MEDICAL - maxillary artery

STUDENTS - superficial temporal artery

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106 - the only medial branch of the external carotid artery is ?

answer - ascending pharyngeal artery .

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107 - which is the smallest cranial nerve ?

answer is - the trochlear nerve or the fourth cranial nerve . It is the smallest nerve in terms of the number of axons it contains .

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108 - which of the following does not form the medial wall of the orbit ?

a- frontal

b- ethmoid

c- lacrimal

d- maxilla

e- sphenoid

f- zygomatic

1 answer is f . the rest all form the medial wall .This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).

2 There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.

3 It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.

4 Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.

5 These transmit nerves and vessels of the same name.

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109 - The Superior Roof of the Orbit

6 The superior wall or roof of the orbit is formed almost completely by the orbital plate of the frontal bone .

7 Posteriorly, the superior wall is formed by the lesser wing of the sphenoid bone .

8 The roof of the orbit is thin, translucent, and gently arched. This plate of bone separates the orbital cavity and the anterior cranial fossa.

9 The optic canal is located in the posterior part of the roof.

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110 - dennie's line is seen in ?

a- leprosy

b- atopic dermatitis

c- tuberculosis

d- hyperthyroidism

answer is b .

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111- post partum hemorrhage is present when blood loss exceeds how much ?

answer : 500 cc .

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112 - commonest cause of post partum hemorrhage in multipara is ?

a- uterine atony

b- fibroid

c- retained placenta

d- uterine perforation

answer is a . uterine atony .

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113 - to decrease PPH the drug used prophylactically is ?

a- oxytocin

b- methergine

c- progesterone

d- prostaglandin

answer is b . methergine .

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114 - commonest form of anthrax ?

a- wool sorters disease

b- alimentary type

c- cutaneous type

d- none of the above

the answer is c . cutaneous type .

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115 - malignant pustule occurs ?

a- melanoma

b- gas gangrene

c- ovarian tumor

d- anthrax

answer is d . anthrax .

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116 - the HIV virus can be transmitted by the following routes except ?

a- homosexual contact

b- intact skin

c- maternofetal

d- needle prick

answer is b .

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117 - uncommon cause of upper GI bleed ?

a- varices

b- erosive gastritis

c- peptic ulcer

d- carcinoma stomach

answer is d . carcinoma stomach .

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118 - curling's ulcer is seen in ?

a- burn patients

b- patients with head injuries

c- zollinger ellison syndrome

d- analegesic drug abuse

answer is a . burn patients .

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119 - linitis plastica is commonly seen in ?

a- carcinoma stomach

b- sarcoidosis

c- lymphoma

d- leiomyosarcoma

answer is a .

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120 - presenting symptom of carcinoma stomach is ?

a- bleeding

b- obstruction

c- perforation

d- weight loss

answer is d - weight loss .

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121 - commonest presentation of carcinoma rectum is ?

a- bleeding per rectum

b- constipation

c- diarrhea

d- feeling of incomplete defecation

answer is a .

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122 - commonest type of anal canal carcinoma ?

a- squamous cell ca.

b- adeno ca .

c- adenocanthoma

d- papillary type

answer is a .

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123 - anal carcinoma is most commonly carcinoma of type ?

a- adenocarcinoma

b- epidermoid

c- mixed

d- none

answer is b . epidermoid .

epidermoid carcinoma of anus includes squamous cell carcinoma , cloacogenic carcinoma , transitional carcinoma and basaloid carcinoma . the clinical picture and natural history of these tumors is similar .

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124 - leonine facies is seen in which type of leprosy ?

a- tuberculoid

b- borderline

c- lepromatous

d- borderline tuberculoid

answer is c . L FOR L .

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125 - the high risk groups for transmission of HIV virus include the following except ?

a- homosexuals

b- hemophiliacs

c- children of HIV mothers

d- health care workers

answer is d . in health care workers there is small but definite risk .

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126 - moth eaten alopecia is seen with ?

answer : syphilis .

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127 - christmas disease is due to which clotting factor deficiency?

answer: ninth factor .

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128 - Which is the most appropriate diuretic for treating acute pulmonary oedema?

A. Loop diuretics

B. Thiazide diuretics

C. Potassium sparing diuretics

D. Osmotic diuretics

answer is A . loop diuretics - acute pulmonary edema .

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129 - Ototoxicity is a unique side effect of which group of diuretics?

A. Loop diuretics

B. Thiazide diuretics

C. Potassium sparing diuretics

D. Osmotic diuretics

answer is a . loop diuretics - ototoxicity .

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130 - Which of the following actions is related to Thiazide diuretics?

A. Hyperuricemia

B. Hyperkalemia

C. Hypoglycemia in Diabetics

D. Hypercalcemia

answer is a . hyperuricemia .

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131 - For which statin, a lower dosage is recommended in Asians as compared to people from western countries?

a-Atorvastatin

b-Simvastatin

c-Rosuvastatin

d-Fluvastatin

answer is c . rosuvastatin .

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132 - Which of the following statins should be given in the evening?

a-Atorvastatin

b-Simvastatin

c-Rosuvastatin

d-All the above

answer is b . simvastatin shud be given in the evening .

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133 - upper part of the medial surface of the pinna is supplied by which nerve ?

answer is lesser occipital nerve ( C2 ) . GREATER AURICULAR NERVE ( C2 , C3 ) - SUPPLIES MOST OF THE MEDIAL SURFACE OF THE PINNA AND ONLY POSTERIOR PART OF THE LATERAL SURFACE.

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134 - WHAT is schwartz sign ?

ans: the reddish hue of the promontory seen in case of otospongiosis thru the tympanic membrane is called the SCHWARTZ SIGN.

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135 - What is PARACUSIS WILLISII?

ans: this is a condition where the patient is able to hear well in noisy surroundings than in normal surroundings . this is because a normal person will raise his voice in noisy surroundings . THIS IS A FEATURE OF A CONDITION CALLED OTOSCLEROSIS ALSO CALLED OTOSPONGIOSIS.

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136 - LABYRINTHINE ARTERY IS A BRANCH OF ?

ANS: THE ANTERIOR INFERIOR CEREBELLAR ARTERY but occasionally BASILAR ARTERY. ( g-300 or g-673 )

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137 - name two congenital deformities of the auricle or pinna ?

ans: CRYPTOTIA AND STAHL'S DEFORMITY.

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138 - what is the other name of cryptotia ? ans: POCKET EAR.

what is the abnormality seen in cryptotia ? ans: upper part of the auricle is buried under the temporal skin .fairly easily mobilised into a more normal position surgically and the posterior

surface of the pinna is covered with skin from the post auricular temporal skin.

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139 - immunoglobulin which crosses the placenta ?

a- Ig A

b- Ig G

c- Ig E

d- Ig D

answer is b . G for GOOD .

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140 - The abductors of the vocal cords are

a. Transverse arytenoid

b. Oblique arytenoid

c. Lateral thyroarytenoid

d. Posterior Cricoarytenoid

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The correct answer is D

The Laryngeal Musculature:

The intrinsic muscles of the larynx, all of which are innervated by the recurrent laryngeal nerve, include:

1) Posterior cricoarytenoid - - the ONLY abductor of the vocal folds. Functions to open the glottis by rotary motion on the arytenoid cartilages. Also tenses cords during phonation.

2) Lateral cricoarytenoid - - functions to close glottis by rotating arytenoids medially.

3) Transverse arytenoid - - only unpaired muscle of the larynx. Functions to approximate bodies of arytenoids closing posterior aspect of glottis.

4) Oblique arytenoid - - this muscle plus action of transverse arytenoid function to close laryngeal introitus during swallowing.

5) Thyroarytenoid - - very broad muscle, usually divided into three parts:

* Thyroarytenoideus internus (vocalis) - adductor and major tensor of free edge of vocal fold.

* Thyroarytenoideus externus - major adductor of vocal fold

* Thyroepiglotticus - shortens vocal ligaments

The cricothyroid muscle is considered to be an extrinsic muscle of the larynx because it is innervated by the external branch of the superior laryngeal nerve. It functions to increase tension in the vocal folds, especially at the upper range of pitch or loudness.

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141 - figure of 8 on x ray is usually seen in?

a-endocardial fibroelastosis

b-ebstein's anamoly

c-total anomalous venous drainage

d-trilocular heart

answer is c . TOTAL ANOMALOUS VENOUS DRAINAGE ( TAPVC ) .

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142 - Regarding the embryology of the thyroid gland:

A. the thyroid develops from ventral pharyngeal gut endoderm. TRUE

B. this development occurs in the 4th week of intrauterine life. TRUE

C. the embryonic thyroid descends from the foramen caecum, situated in the anterior part of the tongue. FALSE

D. The thyroid usually reaches the front of the trachea by the end of 2nd month of intrauterine life. TRUE

E. the thyroglossal duct is originally a hollow tube running from foramen caecum to pharynx. TRUE

F. thyroglossal duct tissue normally becomes solid and remains uncanalised after transit of the thyroid. FALSE

G. The pyramidal lobe of the thyroid represents part of the thyroglossal duct. TRUE

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143 - 90% of brain growth is achieved by the

a) 2nd year

b) 3rd year

c) 5th year

d) 15th year

The correct answer is C

BRAIN GROWTH:

An adult's brain weighs approximately 3 pounds. The brain increases its weight more than three times between birth and adulthood.

* Birth: The brain weighs approximately 350 grams.

* 6 Months: The brain is at approximately 50% of its adult weight.

* 1 Year: The brain weighs approximately 1400 grams. This is approximately 50 - 60% of its adult weight.

* 2 Years: The brain is at 75% of its full weight.

* At age 3, a child’s brain has reached about 90% of its full potential.

* 5 Years: The brain is within 90% of its adult weight.

* 10 Years: The brain is within 95% of its ultimate weight.

* 12 Years: Full brain weight of 3 pounds.

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144 - In paediatrics, the relationship between (classical) onset of rash and day of fever can be memorized as below:

V"ery "S"ick "P"atient "M"ust "T"ake "No" "E"xercise

Day 1 of fever: "v"aricella zoster

Day 2 of fever: "s"carlet fever

Day 3 of fever: small"p"ox

Day 4 of fever: "m"easles

Day 5 of fever: "t"yphus

Day 6 of fever: "no" related disease

Day 7 of fever: "e"nteric fever

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145 - estimation of age of a person by evaluating the physiological changes in teeth is known as ?

GUSTAFFSON'S method.

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146 - The Incubation period of Leprosy is

a) 2-4 days

b) 2-4 weeks

c) 2-4 months

d) 2-4 years

The correct answer is D

Summary of Leprosy

* Infection with Mycobacterium leprae

* Bacteria multiply in the macrophages and Schwann cells of peripheral nerves

* Clinical spectrum: from tuberculoid (paucibacillary) to lepromatous (multibacillary)

* Thickened nerves with neuritis: trophic, motor and sensory disturbances

* Neuropathy leads to paralysis, trophic ulcers, blindness, mutilations

* Skin : numb white area with elevated edge (TT) to diffuse infiltration with nodules (LL).

* In lepromatous leprosy also involvement of deeper tissues (testes, tongue, eyes, etc.)

* Diagnosis clinical, Ziehl staining of smears (skin lesion, nose, earlobe)

* Treatment of leprosy with dapsone, rifampicin, clofazimine

* Leprosy reactions: type 1 (change in immunologic defence) and type 2 (immune complex)

* The majority of infections do not give rise to symptoms (only to a positive lepromine test). After infection there is an incubation period of 2-15 years (the mycobacteria multiply slowly).

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147 - TAMOXIFEN is an anti - estrogen drug . Tamoxifen is an orally active selective estrogen receptor modulator (SERM) which is used in the treatment of breast cancer and is currently the world's largest selling drug for that purpose.

Tamoxifen was discovered by ICI Pharmaceuticals (now AstraZeneca) and is sold under the trade names Nolvadex,® Istubal,® and Valodex.® However, the drug, even before its patent expiration, was and still is widely referred to by its generic name "tamoxifen."

Tamoxifen is used to treat infertility in women with anovulatory disorders. A dose of 10–40 mg per day is administered in days 3–7 of a woman's cycle. In addition, a rare condition occasionally treated with tamoxifen is retroperitoneal fibrosis.

In men, tamoxifen is sometimes used to treat gynecomastia which arises for example as a side effect of antiandrogen prostate cancer treatment.[9] Tamoxifen is also used by bodybuilders to prevent or reduce drug-induced gynecomastia caused by the estrogenic metabolites of anabolic steroids. Tamoxifen is also sometimes used to treat or prevent gynecomastia in sex offenders undergoing treatment by temporary chemical castration.

Finally tamoxifen is used as a research tool to trigger tissue selective gene expression in genetically modified animals using the Cre-Lox recombination technique.

Tamoxifen increases the risk of two types of cancer that can develop in the uterus: endometrial cancer, which arises in the lining of the uterus, and uterine sarcoma, which arises in the muscular wall of the uterus. Like all cancers, endometrial cancer and uterine sarcoma are potentially life-threatening. Women who have had a hysterectomy (surgery to remove the uterus) and are taking tamoxifen are not at increased risk for these cancers.

The Study of Tamoxifen and Raloxifene (STAR) is a clinical trial (a research study conducted with people) designed to see whether the osteoporosis drug raloxifene (Evista®) is more or less effective than tamoxifen in reducing the chance of developing breast cancer in women who are at an increased risk of developing the disease. Raloxifene may have breast cancer risk reduction properties similar to those found in tamoxifen. This study will also examine whether raloxifene has benefits over tamoxifen, such as fewer side effects.

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148 - the estrogen receptor positive breast cancer is

MORE SENSITIVE TO HORMONAL THERAPY

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149 - bluish discoloration of the vagina in early pregnancy is called?

JACQUEMIER' S SIGN OR CHADWICK 'S SIGN .

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150 - length of the eustachian tube ? 36 mm

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151 - length of the external auditory meatus ? 24 mm

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152 - clavulanic acid is used to potentiate the effect of pencillin.

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153 - lesch nyhan syndrome is due to the deficiency of ?

answer : total HGPRT ase ( TOTAL )-

hypoxanthine guanine phospho ribosyl transferase . Enzyme that catalyses the first step in the pathway for salvage of the purines hypoxanthine and guanine. The phosphoribosyl moiety is transferred from an activated precursor, 5-phosphoribosyl 1-pyrophosphate. Since animal cells can synthesize purines de novo , HGPRT-mutants can be selected by their resistance to toxic purine analogues. A genetic lesion in HGPRT in humans underlies the Lesch-Nyhan syndrome.

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154 - posterior cruciate ligament prevents posterior displacement of tibia .

anterior cruciate ligament prevents anterior displacement of tibia .

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155 - SAFE strategy is used in ?

ans : trachoma .

s- surgery

a- antibiotics

f- facial hygeine

e- environmental hygeine

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156 - goniometry is measurement of urethrovesical angle .

helps in prognosis after doing pelvic surgeries like those for stress urinary incontinence like the sling operations.

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157 - staging of the bone tumors was done by - ENNEKING.

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158 - the components of the tetralogy of fallot are

A- OVERRIDING OF AORTA

B- RIGHT OUTFLOW OBSTRUCTION( PULMONIC STENOSIS WHICH CAN BE INFUNDIBULAR

OR VALVULAR )

C- RIGHT VENTRICULAR HYPERTROPHY

D- VENTRICULAR SEPTAL DEFECT

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159 - MEXICAN HAT SIGN - feature of polyps of colon . (barium )

BOWLERS HAT SIGN - feature of both diverticulae and polyps of the colon .( barium )

bowler and batsman . diverticulosis and polyposis of colon .

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160 - Coracoid process of scapula gives attachment to all of the following muscles, EXCEPT ::

a) Pectoralis minor

b) Short head of Biceps brachii

c) Long head of Biceps brachii--------------------------

d) Coracobrachialis

-Pectoralis Minor insertion lies at coracoid process

2 Muscles Originate from its tip

1. Short head of Biceps and

2. Coracobrachialis (Coraco + Brachialis )

so except long head of biceps the coracoid process gives attachment to the remaining three .

The long head of Biceps originates from the Supra Glenoid Tubercle

The long head of Triceps originates from the Infra Glenoid Tubercle

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161 - muscles attached at the greater tuberoisity of the humerus like this: LADY BETWEEN TWO MAJORS

1- lattisumus dorsi,

2- pectoralis major

3- and bicipital tendon,

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162 - the most important side effect of cyclophosphamide ?

answer - hemorrhagic cystitis .

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163 - drugs and their side effects

Cimetidine--------Impotence

Cyclophosphamide---------Haemorrhagic cystitis

Diamorphine-----------Constipation

Amoxicillin------------steven johnson's syndrome

Oral contraceptive pill-----------Deep vein thrombosis

ampicillin-------------Pseudomembranous enterocolitis.

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164 - What is GOLD criteria?

its for COPD.

0=AT RISK BUT NORMAL

1=MILD------------------ -------------------------FEV1/FVC<0.7,>80%

2A=MODERATE "--------------------------- FEV1-50 TO 80%

3 =SEVERE " ,-------------------------------- FEV1 - 30 TO 50%

4 =VERY SEV. " ,---------------------------- FEV1 - <30%>

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165 - Morgagni hernia is

a. Right anterior
b. Left anterior
c. Left posterior
d. Right posterior

answer is a . right anterior morgagni . RAM .

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166 - Maralgia paraesthetica involves

a. Medial cutaneous nerve
b. Lateral cutaneous nerve of thigh
c. Sciatic N
d. Sural N

answer is b . lateral cutaneous nerve of thigh - maralgia paraesthetica .

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167 - TRAP stain - hairy cell leukemia - B cell neoplasm .

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168 - Koplik spots is a feature of

a. Rubella

b. Measles

c. Mumps

d. Tetanus

The correct answer is B. measles .

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169 - Most common drug resistance in tuberculosis, in India, is found for

a) INH

b) Rifampicin

c) Streptomycin

d) Ethambutol

The correct answer is A. isoniazid .

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170 - Gunstock deformity occurs in

a. Supracondylar fracture of femur

b. Intercondylar fracture of femur

c. supracondylar fracture of humerus

d. Distal radial fractures

The correct answer is C

A fracture of the lower humerus besides leaving a valgus deformity, may cause the opposite or a cubitus varus. This is known colloquilly as a gunstock deformity. It may require a osteotomy of the lower humerus to correct this in the future.

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171 - flagella all over the body ?

a- amphitrichous- single flagella on each pole

b- peritrichous---all over - e coli .

c- lopotrichous- bunch one pole

d- monotrichous- one flagella on one pole

answer is b . peritrichous .

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172 - erysipelas is caused by ?

answer is - streptococcus pyogenes .

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173 - scrum pox is seen among players of which sport ?

a- rugby

b- football

c- hockey

d- chess

answer is a . rugby .

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174 - five day self subsiding pain is diagnostic of ?

a- thrombosed external hemorrhoids

b- thrombosed internal hemorrhoids

c- anal fissure

d- fistula-in-ano

answer is a . thrombosed external hemorrhoids .

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175 - for carcinoma anal canal treatment of choice is ?

answer : chemoradiation

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176 - spigelian hernia is seen in ?

a- subumbilical region

b- lumbar triangle

c- paraumbilical

d- supra umbilical

answer is a . subumbilical region .

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177 - most common hernia to strangulate is ?

a- direct inguinal

b- indirect inguinal

c- femoral

d- epigastric

answer is c . femoral hernia .

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178 - hernia into pouch of douglas is called ____ hernia ?

a- berger's hernia

b- beclard's hernia

c- bochdalek's hernia

d- blandin's hernia

answer is a . berger's hernia .

the beclard's hernia is a type of femoral hernia through the opening of the saphenous vein . named after PIERRE AUGUSTIN BECLARD .

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179 - red degeneration of fibroid is due to ?

a- thrombosis of veins

b- infection

c- gangrene

d- rupture of capsules

answer is a . thrombosis of veins .

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180 - red degenration most commonly occurs in which trimester ?

answer - second trimester .

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181 - the uncommon change to occur in a myoma is ?

a- malignant change

b- calcification

c- red degeneration

d- hyaline change

answer is a . malignant change is rare in a myoma .

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182 - commonest site for a fibroid is ?

a- submucous

b- subserous

c- intramural

d- cervical

answer is c . intramural ( malignancy ).

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183 - which of the following is false about fibroid ?

a- rare before 20 years

b- usually asymptomatic

c- more common in nulliparous women

d- usually malignant

answer is d .

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184 - reversibility of tubal ligation is maximum in ?

a- clips

b- pomeroys method

c- irving procedure

d- electro cautery

answer is a .

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185 - norplant is ?

a- subcutaneous implant

b- non steroidal PIU

c- depot tablet

d- IUCD

answer is a .

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186 - best contraceptive for a diabetic female ?

a- oral pills

b- IUCD

c- condom by husband

d- today sponge

answer is c .

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187 - progestasert is effective for ?

a- 1 year

b- 2 years

c- 3 years

d- 4 years

answer is a . 1 year .

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188 - incidence of ectopic pregnancy is highest with ?

a- O C P

b- copper T

c- multiload IUCD

d- progestasert

answer is d . progestasert .

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189 - life for as long as 10 years is for which IUCD ?

a- Cu T 200

b- Cu 250

c- Cu T 380 A

d- progestasert

answer is c.

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190 - IUCD with shortest life span ?

answer : progestasert .

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191 - IUCD Cu T 200 - what is 200?

answer : 200 square mm of copper .

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192 - mechanism of action of progesterone only pill ?

a- makes mucus viscid

b- prevents ovulation

c- anti spermatozoic

d- none

answer is a .

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193 - which of the following may be used for post - coital contraception ?

a- Cu - T

b- RU 486

c- estrogen in high doses

d- all the above

answer is d . all the above .

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194 - method of sterilisation least suited for recanalisation ?

a- clips

b- bipolar cauterisation

c- fallopian rings

d- pomeroys technique

answer is b . bipolar cauterisation .

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195 - used in the treatment of endometriosis ?

a- medroxy progesterone acetate

b- OCP

c- progesterone

d- danazol

e- GnRH

f- oestrogen

h- tibolone

i- testosterone

answers are a , b , c , d and e . oestrogen, testosterone and tibolone are not used in the treatment of endometriosis . GOD; MP . member of parliament .

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196 - best investigation to establish the diagnosis of endometriosis is ?

a- laparoscopy

b- USG

c- x ray pelvis

d- CT scan

answer is a . laparoscopy .

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197 - in cervical incontinence the encirclage operations done are ?

a- shirodkar operation

b- mc donalds operation

c- purandare

d- khanna's sling

e- abdominal sling

answers are a and b . remember the mnemonic , MRS . SHIRODKAR WENT TO Mc DONALDS INSPITE OF HAVING CERVICAL INCOMPETENCE .

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198 - the implantation occurs on which day ?

answer is - 7 - 9 days after ovulation .

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199 - congenital anamolies are most severe with ?

a- rubella infection

b- mumps

c- CMV

d- toxoplasma

answer is a .

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200 - which drug is given to prevent HIV transmission from mother to child ?

answer - NEVIRAPINE .

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